Swine-like hepatitis E viruses are a cause of unexplained hepatitis in the Netherlands

被引:62
作者
Herremans, M.
Vennema, H.
Bakker, J.
van der Veer, B.
Duizer, E.
Benne, C. A.
Waar, K.
Hendrixks, B.
Schneeberger, P.
Blaauw, G.
Kooiman, M.
Koopmans, M. P. G.
机构
[1] Natl Inst Publ Hlth & Environm, Diagnost Lab Infect Dis & Perinatal Screening, NL-3720 BA Bilthoven, Netherlands
[2] Infect Dis Lab, Groningen, Netherlands
[3] Publ Hlth Lab, Friesland, Netherlands
[4] Reg Publ Hlth Lab, Zeeland, Netherlands
[5] Jeroen Bosch Hosp, Shertogenbosch, Netherlands
关键词
anti-hepatitis E; hepatitis E virus; reverse transcriptase-polymerase chain reaction; seroprevalence; the Netherlands;
D O I
10.1111/j.1365-2893.2006.00786.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Hepatitis E virus (HEV) infections in developed countries are recognized as an imported disease related to travel to endemic regions. However, increasing evidence suggests that HEV infection may also occur in the developed countries and that swine may act as a possible reservoir. To investigate the indigenous transmission of HEV in the Netherlands, sera from 50 blood donors and 1027 sera from patients with acute hepatitis were screened with an ELISA for HEV-specific IgG and IgM. Because the Netherlands is considered a nonendemic region, all positive ELISA results were confirmed by immunoblot to exclude false-positive results. Evidence of recent HEV infection was detected in 0% of the blood donors and 4.4% of the cases, based on combined positive IgM and IgG responses. The serodiagnosis was confirmed by a positive polymerase chain reaction (PCR) in 24 patients with hepatitis (2.3% overall, 51% of confirmed IgM+/IgG+ cases). IgG antibodies alone were detected in 4.2% of patients. We found related sequences to virus strains detected in Dutch pigs (genotype 3, 91-97% homology) in 89% of PCR-confirmed HEV patients. The detection of unique swine-like HEV sequences in 16 indigenous hepatitis patients without a recent travel history suggests that HEV is endemic in the Netherlands. We recommend including HEV tests in unexplained acute hepatitis patients, despite their travel history.
引用
收藏
页码:140 / 146
页数:7
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